Sifting through the clutter: Addressing breastfeeding challenges in the Catholic Church

Editor’s note: Even though my eldest is now in college, I have vivid memories of being a young mom, attempting to breastfeed my baby, and falling flat on my face. That’s why I am thrilled to welcome new contributor Jaime Buelterman who will join us once per quarter to share her wonderful perspective on this important topic. Please join me in welcoming Jaime. Feel free to leave your questions for her in the comments section. LMH

“I didn’t make enough milk”

“The baby would not latch”

“They did not tell me the pill would dry up my milk”

“My doctor told me that formula was just as good”

These are comments often made in passing from mothers. The last two are especially disturbing to me. It takes a great deal to hold composure in some situations and not let my frustration show while working with a mom. It is no secret these statements made by a friend or family member can plant the seed that leads to failure. The power of the media, peer influence, and that of a physician are recognized in the ability to shape the course a person will decide upon, even if a mother is aware of the risk.

Last year the Surgeon General released a “Call to action to support breastfeeding in the community”. I had the honor of presenting a portion of it at Cincinnati Children’s Hospital. While gathering materials for the topic, I noticed a specific suggestion of utilizing churches in the effort to increase breastfeeding rates. Even the government recognizes the importance of faith in the decisions a family makes in regards to child rearing. Living in Cincinnati, we are blessed to have many experts in the field of lactation and NFP. I began to inquire as to why there was little being done by the Catholic Church to culturally support breastfeeding, especially since it was so important to the success of spacing children while practicing NFP (Natural Family Planning). The responses were all very different, but indicative of distress. Support of NFP in and of itself are a challenge, much less addressing the decision to breastfeed, which is not considered a moral issue, but a recommendation.

While there are steps to protect mothers in the hospital through the Baby Friendly Initiative, not every hospital participates. The next question remains: what happens to mom after she goes home? Some hospitals offer a limited post partum follow up, or a visiting nurse. Most often, it is during these days that trouble arises, and there is no one to offer critical guidance to a mother, or even simple encouragement that “this too shall pass”. Even worse, there is damaging advice from a nurse or a physician, in whom we often place complete trust.

We as a faith community hold a unique advantage in our society. We honor fertility, advocate breastfeeding, support the family structure, and hold steadfast to community in the gathering of saints. We are also nestled deep in the urban communities and rural areas of America, where accurate information is often hard to come by, especially for underserved populations. All of these components are critical. Women are often unaware of the impacts of IVF, hormonal contraceptives, and pre-existing health conditions in relation to breastfeeding successfully. Catholic mothers also face the distinct challenge of finding health providers knowledgeable on the vast information about NFP, and in conjunction LAM (Lactation Amenorrhea). We know that a large percentage of women do not practice NFP, but what better opportunity to open the door for loving education then during her pregnancy, or when problems with fertility arise?

Science is catching up where doctrine has always been deeply rooted, which too works in our favor. It is important to remember that many women are hesitant to reach out for assistance. The Elizabeth Ministry International, Catholic Nursing Mothers League, NFP and more, and Birthright International are some examples of groups that fully recognize the importance of mother-to-mother connections, and providing accurate resources to women in the Catholic Church, while providing outreach education. Do not be lost on the wonder of the Visitation. God was preparing Mary for what was to come. Humanity has thrived due to the nurturing instincts we possess, and we are responsible for ensuring that the women in our life do not have to “sift through the clutter” to find accurate information and suffer needlessly.

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12 Comments

Very glad to see articles by someone with your credentials! What advice do you have for someone with 1 inverted nipple? I tried (and failed) to breastfeed my first son, I sought a lactation consultant who could only offer me a nipple shield which my son hated completely and refused to even try. My milk production was good, so I began to use a double electric pump to express milk for him, he thrived. I did this every 2-3 hours for 4 months and then fell flat on my face from exhaustion (I also homeschool our 2 teens) and frustration at which point my husband intervened and bought formula. I am expecting again and dearly want to breastfeed…for now, planning on pumping again, for as long as I can take it…please help.

Amy, my first advice would be to find a different lactation consultant or find a very seasoned La Leche League Leader. There are other strategies than nipple shields for latching on nipples that aren’t very everted (whether flat or inverted). There are devices like Supple cups (a brand name) that are reported to help a nipple to evert even after birth and there are breast shields that can be word for a few hours a day during late pregnancy that some moms have found helpful, although the research doesn’t necessarily confirm that. Sometimes your breast pump will pull the nipple out sufficiently that the baby finds he’s now got a nice everted nipple temporarily. Since you have only one inverted nipple you also have the option of only nursing on one breast. You could pump the other enough to relieve pressure at the beginning and just allow it to gradually dry up. Mothers of twins are feeding each baby on only one breast and mothers who’ve had mastectomies are able to as well. Supply and demand works well here. You just have to make sure to feed frequently at the beginning so that your milk supply in that breast gets calibrated to your baby’s need in the first month.

I suspect that the reason your baby hated the nipple shield was that he was getting the real thing on the other side and got very confused about the difference in feel, as well as the different motion he had to make with his mouth with the shield. My own first baby encountered flat nipples when he was born. Interestingly, our first nursing went fine (great nurse), but when it came to the second (different hospital shift) the nurse threw up her hands in disgust and brought me a shield. We ended up on the nipple shield for 3 weeks. I was increasingly frustrated with it (this was bake in the day of rubber/latex shields which were much harder to use than the silcone ones). Then my local LLL Leader (who was also a friend from church) dropped by to drop off a baby gift. I explained that I couldn’t get him to nurse without the shield, but was getting frustrated with the shield because boiling it to sterilize it had made it harder and harder to use. She suggested that I try again without it, and lo and behold he latched beautifully and we never used the shield again.

There are anatomical reasons why babies sometimes have difficulty nursing with an inverted nipple, but in fact if the baby gets enough breast tissue in their mouth many babies are able to nurse just fine with a nipple that is either flat or inverted. It really is one of those, you simply don’t know until you try it situations. Different babies respond differently to nipple anomalies. Your next baby may take it all in stride.

Since you’re still pregnant at this point, my first piece of advice would be to seek out a La Leche League meeting now, while you’ve still got time before the baby is born. LLL Leaders are frequently as competent (and sometimes more competent) than some lactation consultants. Also consumers frequently get confused between lactation consultants (who have to have quite a bit of clinical experience and pass a stringent exam) and lactation counselors (who may have taken only a 25 hour class with no hands on experience at all). The really good thing about a seasoned LLL Leader is that she’s seen all kinds of situations, she’s nursed at least one baby for at least a year, and she’ll know when her help isn’t enough, and probably can recommend an IBCLC who might be better at helping you. At a LLL meeting you’ll also meet other mothers who’ve worked through challenges, and sometimes (by Providence or serendipity) there will be a mother there who’s faced the same challenge as you. It really does happen, I’ve seen it.

Be willing to be patient and flexible in working with your baby, and be willing to try some different positions for nursing. The classic cradle hold works well in a lot of situations, but sometimes when there are difficulties other positions actually give the baby a better chance to get a good mouthful of breast tissue, and then you find that the nipple is in fact simply a faucet (as someone mentioned at the conference I was at yesterday) and that so long as the milk comes out, it really doesn’t matter what the shape of the faucet itself. One of the difficulty in the very early days (once the mature milk is beginning to come in) is that the breast itself can be swollen causing the whole areola to be very taut. For mothers with very everted nipples this isn’t such a problem. For mothers with flattened or inverted nipples it can make things even more difficult. Ask your LLL Leader to show you how to do reverse pressure softening so that you can avoid presenting your baby with a breast that’s too tough for him to form into a teat.

It’s really worth it to seek out a LLL meeting, even if you have to travel a bit to get to one. We have moms that have come from as far away and an hour and forty five minutes to get to our meeting. In some areas you may find a meeting just minutes away. It all depends on where in the country you are located. If you check out the La Leche League website you will find information on finding a local group. I’d also be happy to talk with you. I’ll be notified of followup comments on this post.

The best of luck to you and your baby. Please believe that this is not an impossible situation a truly skilled helper will be able to work with you. There are ways to work with less than perfect anatomy. Also for Catholic moms I highly recommend Sheila Kippley’s books (especially her one on breastfeeding and Catholic motherhood).

I’d like to comment here that a friend tried to get an article on the connection between breastfeeding and NFP into our diocesan magazine only to be turned down very firmly by the editor on any reference to breastfeeding at all. My friend had done a lot of research (she’s a college professor, so she definitely writes well) on the theology of breastfeeding and the Church’s support for it. There’s evidence out there that ecological breastfeeding is really a help to families seeking to have some spacing between their children. The problem seems to still be that a lot of people in the Church at local and diocesan levels are still uncomfortable with the topic. That’s a cultural dilemma we still have to address. I’m a convert and was still Protestant when nursing my babies. I always nursed (very discretely) comfortably in church. I was astonished to discover that Catholic women of both my era and the current one mostly duck into confessionals, bring bottles for the baby to have in church, or go to another part of the church to nurse their baby. In the entire time I’ve been Catholic I’ve seen only one baby being nursed in church. I noticed it because as a former nursing mom I could tell the difference between a baby who was just being held and one that was being nursed, even though you couldn’t “see” anything. I think we really do need to address the question because moms need support for breastfeeding, even at church.

Catholic Mother’s Nursing League is great (where they have groups – which is still quite limited) in offering support. What they don’t offer (because of lack of insurance) is the kind of help for breastfeeding difficulties that La Leche League is able to offer. LLL was started by 7 Catholic women and although it chose to be non-sectarian, still has some very Catholic principles underlying its philosophy. A local Leader will probably not be Catholic (although it’s possible that she is), but she will have good training in helping a mom to achieve her breastfeeding goals. Some LLL libraries will still have a copy of Breastfeeding and Natural Child Spacing (ours does). The biggest things that LLL Leaders bring to the plate are personal experience with breastfeeding and good training in both breastfeeding difficulties, and communication skills. A mother who lives where there is a CMNL group might still be well advised to seek out her local LLL group as well if she encounters any difficulty in breastfeeding.

“I began to inquire as to why there was little being done by the Catholic Church to culturally support breastfeeding, especially since it was so essential to the success of spacing children while practicing NFP (Natural Family Planning).”

It is wrong to say that breastfeeding is ESSENTIAL to prayerfully discerned spacing. It may make it EASIER, but it isn’t essential. I think that this gives the mistaken impression that NFP isn’t effective. I do agree wholeheartedy with your other points regarding the need for more breastfeeding support (both how-to and acceptance of discrete “public” nursing). I think this support needs to extend to the beauty and effectiveness of NFP as well.

I write from the perspective of a mother of 5. All received my milk. The first 3 via exclusive breastfeeding. I was CRUSHED when the fourth was unable to transfer milk and gain weight. In spite of support of several sources and much trying, ultimately he received my breastmilk via bottles for a year. Despite efforts to the contrary, I am doing the same with my fifth. It wasn’t my plan, but God has blessed us in spite of our challenges. These last two babes are still snuggled, loved, and travel just about everywhere with Mommy. We still look to God to guide our family, practice NFP, and are grateful for the blessings of our kids. I’m not implying that you were doing this in your article, but I do think we need to be careful not to make assumptions about that Mom holding the bottle as we don’t know her whole story.

Thank you for your effots to encourage and support women in accepting the beautiful (albeit sometimes challenging!) gift God gives in breastfeeding our children.

L, I would absolutely agree with you that people can use NFP without breastfeeding. What I would say that the experience of my daughter’s friends has demonstrated is that using NFP while breastfeeding can have challenges for those who are not practicing the standards of either the Lactational Amenorrhea Method or Ecological Breastfeeding. We know at least two young couples who chose to simply abstain for months on end because they couldn’t afford another baby (either physically or financially) at that time and charting while breastfeeding before return cycles become very stable is not easy for a neophyte. One of the reasons that Sheila Kippley first wrote her books was that couples were being encouraged to wean rather quickly in order to get back to more easily monitored cycles.

You make an excellent point about not making assumptions about mothers who are bottle feeding. We recently had a mom come to our LLL group who struggled with low supply due to physical reasons as well as very poor information about the importance of early milk calibration. She desperately wanted to nurse her baby. Through the years I’ve met other moms whose dreams of breastfeeding a particular baby had to die due to problems with the baby itself. The difficulty for breastfeeding mothers is that frequently society itself has enculturated what should be a practice that was developed for difficult situations. I am absolutely supportive of their being safe formula available for babies who need it. The very first rule of lactation counseling is “feed the baby.” Sometimes that means assisting the mother in achieving a good latch, sometimes it’s helping her rebuild her supply, sometimes it’s helping her realize that for whatever reason she’s never going to be able to feed this baby exclusively at the breast. However, it’s wrong when mothers who are wanting to provide their own milk to their babies are informed that if they want to do so in public spaces (including Mass) that they should pump and bottle. It’s like saying that because some people have to use crutches, eyeglasses, or hearing aids, everyone should have to do so.

What is not being discussed in NFP conversations is the aid that ecological breastfeeding can have in child spacing. For the average woman it means that fertility doesn’t return until 14.5 months post-partum, for many it means that fertility doesn’t return until even later than that. For moms who’ve had c-sections in particular, this information may actually help them to avoid a repeat section due to their pregnancies being spaced too closely. It also means that many couples can throw the charts out altogether, at least for a period of time. Sadly most couples don’t get this information about a woman’s basic biology even in the NFP discussions at Pre-Cana. The topic of breastfeeding, at least in our diocese, seems to be hush-hush.

I personally can’t even begin to imagine how crushed you must have been to find that you couldn’t nurse your last two babies. Nursing is such a wonderful mothering tool, that to be denied it must have been a real heartache for you. What you brought into that experience, however, was not only the milk you provided your babies, but all of the wonderful mothering tools that you acquired while you were breastfeeding your older children. Your children have been blessed to have you as their mother because you clearly put their needs first.

Amy,
I am happy you have found hope in this article. Liz has provided a great deal of insight, while sharing the same recommendation I would have. It is imporant to seek out competent breastfeeding assistance. When speaking to some one who claims to be a “Lactation Consultant”, make sure they recieved credentialing through the International Board of Certified Lacation Consultants. or IBCLC for short. La Leche League has some very knowledgeable leaders as well, and can provide the additional support you may need. Being able to connect with some one who has experienced it personally or understands can be life changing.

Liz,
You are right, my use of “essential” was incorrect. I will have it changed. There are indeed other methods for monitoring fertility. And as you also mentioned, if not able to practice ecological breastfeeding, in addition to other obstacles, can be a challenge. These comments only highlight the difficulties women are experiencing, and bring up another point. There are so many variables in the the process of NFP, many health professionals do not recommend it because of the dedication and dilligence necessary. From the general public point of view, this is the perspective. The problem is, many women in public institutions are treated under this point of view.
The focus is what is effective, easy, and expensive. Not what is best.
The true reality of couples obstaining for months on end is commendable, yet very unique. If that is the solution for some couples though, I can very easily see formula use becoming a justified option, because it not considered a moral issue.

There are also many women in our parishes who may be intimidated by those who practice NFP, and ecological breastfeeding if they are not. Therefore they may not receive the emotional support and guidance they need, because of a fear or actual encounter with judgment. I know this to be true, because I hear these things all the time and experienced some of them personally.

What you did for Amy was a prime example of what needs to happen. You took the initiative to reach out and provide information that was appropriate for her. You provided her with several options. How many mothers in our pews actually know some one like you? Thank you for sharing, both of you ladies. That is how these barriers will be overcome, by walking in humility and sharing in love.

Kathleen,
You are one of the only physicians I have ever met who has openly admitted to these challenges. We know that they happen, but what you have done is a huge step in bringing this situation to light. It is critical you continue to share your message, so those of us in the community have that tool to give to families. You have been very inspiring in me stepping out in faith!

Ladies please forgive me for not properly seperating the comments made by L. and Liz. The issues you speak of are all very valid. It is unfortunate if you have a Diocese that is unsupportive of breastfeeding. I encourage you to contact Couples to Couples League or NPFandMore.org to see if there are teaching couples and open clergy in your area to support your mission. The parish may be unaware of the assistance that can be offered to new parents as well. I would see if La Leche League information can be distributed at the classes so parents know who they are. I would also contact the Family Life division at the Diocese to find out what the conflict is. You may be able to help resolve it. Every problem is an opportunity in disguise.

A word has been edited in the comment “I began to inquire as to why there was little being done by the Catholic Church to culturally support breastfeeding, especially since it was so essential to the success of spacing children while practicing NFP (Natural Family Planning).” has been changed. “essential” is now “important”.

Any questions about Natural Family Planning should be directed to the appropriate authority. Please contact one of the links listed on the bottom of the article.

I loved this post—as a former LLLLeader, I understand the challenges that face new moms trying to breastfeed. But I was discouraged to see that on the web page where I read your post, an ad popped up for free baby formula.